| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
42,061 |
36,164 |
$2.49M |
| 0762 |
|
2,965 |
1,677 |
$1.08M |
| 70450 |
|
3,245 |
3,035 |
$601K |
| 96374 |
|
6,060 |
5,349 |
$418K |
| 96360 |
|
4,952 |
4,556 |
$363K |
| 74176 |
|
2,887 |
2,706 |
$351K |
| 80053 |
|
16,388 |
14,207 |
$264K |
| G0480 |
Drug test def 1-7 classes |
3,424 |
3,037 |
$249K |
| 74177 |
|
943 |
887 |
$235K |
| Z7502 |
|
6,072 |
5,947 |
$227K |
| 85025 |
|
18,473 |
15,878 |
$211K |
| 93005 |
|
6,302 |
5,565 |
$183K |
| 0360 |
|
1,662 |
941 |
$167K |
| 0750 |
|
1,272 |
1,085 |
$141K |
| 71045 |
|
7,723 |
7,099 |
$110K |
| 96361 |
|
4,873 |
4,457 |
$98K |
| 81025 |
|
10,950 |
9,851 |
$90K |
| 96372 |
|
3,255 |
2,869 |
$87K |
| 72125 |
|
365 |
343 |
$84K |
| 83690 |
|
7,408 |
6,698 |
$79K |
| 82553 |
|
4,540 |
4,030 |
$72K |
| 96379 |
|
1,959 |
1,814 |
$70K |
| 76705 |
|
1,097 |
1,038 |
$65K |
| 84484 |
|
4,695 |
4,132 |
$63K |
| 82150 |
|
6,236 |
5,691 |
$62K |
| 71046 |
|
2,136 |
1,988 |
$56K |
| 81003 |
|
16,069 |
12,816 |
$54K |
| 83880 |
|
2,137 |
1,916 |
$46K |
| 85730 |
|
5,449 |
4,986 |
$45K |
| 76801 |
|
665 |
563 |
$44K |
| 82550 |
|
4,716 |
4,187 |
$41K |
| 76856 |
|
567 |
551 |
$37K |
| 76830 |
|
493 |
477 |
$32K |
| 99284 |
|
687 |
624 |
$31K |
| 85610 |
|
5,735 |
5,235 |
$30K |
| 70486 |
|
136 |
134 |
$29K |
| J3490 |
Drugs unclassified injection |
14,553 |
12,497 |
$28K |
| 74018 |
|
1,314 |
1,238 |
$28K |
| 99283 |
|
580 |
528 |
$28K |
| 0710 |
|
968 |
913 |
$27K |
| 59025 |
|
1,409 |
945 |
$25K |
| Z9725 |
|
827 |
822 |
$25K |
| J7030 |
Normal saline solution infus |
6,173 |
5,461 |
$24K |
| 84703 |
|
1,947 |
1,847 |
$22K |
| 93971 |
|
191 |
178 |
$22K |
| 83605 |
|
1,427 |
1,287 |
$21K |
| 94640 |
|
1,059 |
879 |
$21K |
| 96375 |
|
602 |
548 |
$20K |
| 82947 |
|
4,287 |
3,342 |
$20K |
| 99499 |
|
300 |
271 |
$19K |
| 73610 |
|
700 |
670 |
$19K |
| 88305 |
|
1,387 |
1,314 |
$19K |
| 73630 |
|
721 |
687 |
$18K |
| 84702 |
|
958 |
808 |
$18K |
| 90715 |
|
526 |
500 |
$18K |
| 76817 |
|
302 |
256 |
$18K |
| 72100 |
|
577 |
548 |
$18K |
| 84443 |
|
706 |
659 |
$17K |
| 87086 |
|
1,857 |
1,723 |
$16K |
| Z7610 |
|
1,316 |
1,265 |
$16K |
| 73130 |
|
579 |
544 |
$16K |
| 99070 |
|
6,526 |
5,005 |
$15K |
| 87040 |
|
1,039 |
948 |
$14K |
| 73030 |
|
531 |
511 |
$14K |
| 73564 |
|
477 |
453 |
$14K |
| 80048 |
|
1,116 |
1,034 |
$14K |
| 99282 |
|
646 |
561 |
$14K |
| 87400 |
|
2,090 |
1,926 |
$12K |
| J1885 |
Ketorolac tromethamine inj |
5,063 |
4,637 |
$11K |
| 73110 |
|
358 |
339 |
$10K |
| 81001 |
|
1,822 |
1,675 |
$10K |
| G0378 |
Hospital observation per hr |
38 |
12 |
$9K |
| 71275 |
|
37 |
37 |
$9K |
| 99285 |
|
130 |
111 |
$9K |
| 87420 |
|
563 |
524 |
$8K |
| 43239 |
|
555 |
524 |
$8K |
| J2270 |
Morphine sulfate injection |
2,390 |
2,021 |
$8K |
| 72131 |
|
32 |
27 |
$8K |
| 85379 |
|
411 |
395 |
$7K |
| 88313 |
|
659 |
626 |
$7K |
| J2405 |
Ondansetron hcl injection |
4,515 |
4,051 |
$7K |
| 82140 |
|
430 |
339 |
$7K |
| 73080 |
|
238 |
227 |
$6K |
| 87491 |
|
111 |
109 |
$6K |
| 99281 |
|
383 |
320 |
$6K |
| 86901 |
|
977 |
903 |
$6K |
| J2710 |
Neostigmine methylslfte inj |
254 |
232 |
$5K |
| 86140 |
|
730 |
653 |
$5K |
| J1170 |
Hydromorphone injection |
1,425 |
1,194 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
1,979 |
1,802 |
$5K |
| 86850 |
|
556 |
525 |
$5K |
| 88312 |
|
612 |
580 |
$5K |
| A0429 |
Bls-emergency |
150 |
120 |
$5K |
| J2930 |
Methylprednisolone injection |
462 |
419 |
$4K |
| 73140 |
|
260 |
237 |
$4K |
| J7120 |
Ringers lactate infusion |
1,086 |
948 |
$4K |
| J1100 |
Dexamethasone sodium phos |
2,755 |
2,591 |
$4K |
| 83735 |
|
584 |
394 |
$4K |
| 76805 |
|
43 |
41 |
$4K |
| 36415 |
|
436 |
302 |
$4K |
| 86900 |
|
976 |
902 |
$4K |
| 12001 |
|
252 |
238 |
$4K |
| 71250 |
|
16 |
13 |
$4K |
| 72040 |
|
119 |
119 |
$3K |
| 82803 |
|
131 |
115 |
$3K |
| 73590 |
|
151 |
145 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
504 |
447 |
$3K |
| J7050 |
Normal saline solution infus |
1,774 |
1,468 |
$3K |
| 76815 |
|
74 |
65 |
$3K |
| J3010 |
Fentanyl citrate injection |
1,960 |
1,841 |
$3K |
| 71010 |
|
166 |
148 |
$3K |
| 29125 |
|
397 |
369 |
$2K |
| 73090 |
|
110 |
108 |
$2K |
| 45380 |
|
185 |
172 |
$2K |
| 93307 |
|
14 |
12 |
$2K |
| 83036 |
|
185 |
168 |
$2K |
| J7040 |
Normal saline solution infus |
1,456 |
1,334 |
$2K |
| J2175 |
Meperidine hydrochl /100 mg |
413 |
384 |
$2K |
| 29540 |
|
239 |
228 |
$2K |
| 71020 |
|
58 |
49 |
$2K |
| J2550 |
Promethazine hcl injection |
701 |
645 |
$2K |
| 12011 |
|
71 |
66 |
$2K |
| 73562 |
|
70 |
67 |
$2K |
| 29515 |
|
192 |
176 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
1,900 |
1,746 |
$1K |
| J2060 |
Lorazepam injection |
842 |
755 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
867 |
768 |
$1K |
| 82010 |
|
100 |
93 |
$1K |
| J2765 |
Metoclopramide hcl injection |
530 |
485 |
$1K |
| 84145 |
|
73 |
67 |
$1K |
| 87088 |
|
146 |
142 |
$1K |
| 80076 |
|
189 |
172 |
$1K |
| 29530 |
|
130 |
118 |
$943.32 |
| 87591 |
|
15 |
15 |
$934.27 |
| 74000 |
|
43 |
41 |
$859.80 |
| 88307 |
|
41 |
39 |
$834.94 |
| 84550 |
|
144 |
130 |
$790.22 |
| 0250 |
|
674 |
515 |
$735.65 |
| 10060 |
|
42 |
39 |
$728.87 |
| 71101 |
|
14 |
14 |
$719.46 |
| 85652 |
|
206 |
157 |
$662.12 |
| J0690 |
Cefazolin sodium injection |
352 |
320 |
$645.21 |
| J2001 |
Lidocaine injection |
649 |
598 |
$635.35 |
| 74022 |
|
12 |
12 |
$587.55 |
| 87070 |
|
58 |
56 |
$582.38 |
| E0110 |
Crutch forearm pair |
16 |
16 |
$574.89 |
| 84100 |
|
116 |
74 |
$565.74 |
| 82247 |
|
99 |
78 |
$562.32 |
| 29105 |
|
71 |
67 |
$502.38 |
| 81015 |
|
260 |
226 |
$421.93 |
| 73502 |
|
14 |
14 |
$372.39 |
| 0270 |
|
155 |
148 |
$220.82 |
| 12002 |
|
15 |
15 |
$210.00 |
| 29130 |
|
26 |
26 |
$191.94 |
| 45378 |
|
13 |
12 |
$180.00 |
| 29505 |
|
17 |
12 |
$122.22 |
| 45381 |
|
13 |
12 |
$100.00 |
| 80061 |
|
14 |
12 |
$99.50 |
| J0330 |
Succinycholine chloride inj |
13 |
13 |
$79.61 |
| 90471 |
|
14 |
14 |
$66.96 |
| J2543 |
Piperacillin/tazobactam |
27 |
24 |
$55.81 |
| J3370 |
Vancomycin hcl injection |
13 |
12 |
$55.51 |
| J1815 |
Insulin injection |
43 |
27 |
$54.31 |
| 85007 |
|
19 |
14 |
$52.26 |
| J7620 |
Albuterol ipratrop non-comp |
404 |
365 |
$50.37 |
| 89060 |
|
14 |
14 |
$33.96 |
| J1650 |
Inj enoxaparin sodium |
41 |
24 |
$27.98 |
| A9270 |
Non-covered item or service |
614 |
448 |
$10.34 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
48 |
44 |
$4.09 |
| J7644 |
Ipratropium bromide non-comp |
12 |
12 |
$2.60 |
| J7512 |
Prednisone ir or dr oral 1mg |
14 |
14 |
$0.13 |